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Unfair Claims Settlement Practices
When insurers receive a claim or suit from an insured or third party, they must first make sure that subsequent actions by all parties are in accordance with the conditions required by the policy and applicable laws and regulations. Violating such conditions and guidelines can lead to unintended consequences. For example, courts could refuse to uphold claims denials and possibly recognize bad faith suits, instead. Or an insurance department could find that the insurer broke a law and subsequently impose regulatory penalties. This article discusses how to avoid such outcomes by discussing important, but basic, dos and don’ts, illustrated through real-life examples.
Michelle Villarreal began her claims career over 30 years ago, with Cigna Companies while attending St. Mary’s University in San Antonio. She is the President and CEO of Occupational Accident Risk, Inc, a Third Party Administrator specializing in Texas work injury programs. They have been in the Third Party Administration industry since 2006, offering services…
Jane Marie Downey, ARM, M. Ed Principal Risk Consultant, Clarity Concepts, Inc. Jane Downey is an internationally known Risk Management consultant and Insurance industry expert. Jane has a background in both Insurance brokerage and Risk Management. Her specialty industries include manufacturing, financial institutions, and technology risks. She has made many Risk Management reports to…
Steve is a 30+ year veteran of property and casualty insurance claims. He holds the CPCU and AIC designations and is Past President (2006) of the National Society of Professional Insurance Investigators (NSPII). Over the course of his carrier career, Steve worked as a direct claim handler, manager, litigation examiner, senior claim specialist and director…
I serve as the Principal of Insurance Claims and Litigation Consultants, LLC, a firm that provides expert witness services and testimony on claims and lawsuits involving insurance coverage, bad faith, underwriting, agent-broker liability, regulatory issues and good faith claims handling practices. I also provide consultation and oversight of pre-suit and litigated coverage matters that potentially…
Lezlee Liljenberg, entered the insurance business in 2004 as she started her first agency from ground zero, growing the business to over $6 million in revenue in less than 12 years. Ms. Liljenberg holds a BA in Journalism/Public Relations and a MA in Political Science/Public Administration from the University of Texas at Arlington. She is…
Tommy Michaels of T. R. Michaels Claim Consulting, LLC has over 50 years experience in property and casualty insurance claims handling and claims administration. 36 years with a major insurer in various claim capacities including home office executive. Expert testimony provided in Federal and State courts throughout the United States regarding bad faith, claims standards,…
